The effect of bisphosphonate therapy on reducing the risk of cardiovascular complications associated with chronic heart failure, type 2 diabetes and osteoporosis in postmenopausal women


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Abstract

Aim. To study the effectiveness of oral alendronate and ibandronate bisphosphonates for the prevention of cardiovascular complications in postmenopausal women with type 2 diabetes mellitus (DM) and osteoporosis during a 12-month prospective observation. Materials and methods. The study included 86 women with osteoporosis, chronic heart failure (CHF) and type 2 diabetes: the 1st group (n=52) included patients who received basic therapy for heart failure; the 2nd group (n=34) included patients who, in addition to the basic therapy of heart failure, were prescribed alendronic and ibandronic acid preparations for the treatment of osteoporosis. In order to identify the possibility of associating the studied factors with the nature of the course of heart failure, the patients were divided according to the results of a one - year follow - up into two subgroups: subgroup A (n=49) - patients with a favorable course of the disease and subgroup B (n=37) - patients with an unfavorable course of pathology. Results and discussion. After 12 months, a significant decrease in the levels of cerebral natriuretic peptide precursor (NT-proBNP), tumor necrosis factor-α, and interleukin-1β was found in the group of women treated with bisphosphonates compared to baseline. Significant associations of NT-proBNP levels (p=0.02) and the studied cytokines (p=0.01) with an unfavorable course of heart failure were revealed. A significant association of bisphosphonate therapy with a favorable course of heart failure (p=0.01) was also revealed. The probability of developing adverse cardiovascular events during the year in the treatment of heart failure with basic therapy drugs with additional therapy of osteoporosis with bisphosphonates is significantly (p=0.0025) lower than the treatment of patients with heart failure with only basic therapy and not taking bisphosphonates for the treatment of osteoporosis. Conclusion. In postmenopausal women with associated cardiovascular pathology (CHF, type 2 diabetes and osteoporosis), prophylactic therapy with oral alendronate and ibandronate oral bisphosphonates is effective, reduces the risk of progression of heart failure, inhibits inflammatory mediators, positively affects the combined endpoints of comorbid cardiovascular pathology.

About the authors

A T Teplyakov

Cardiology Research Institute, Tomsk National Research Medical Center

д.м.н., проф., гл.н.с. НИИ кардиологии ТНИМЦ; ORCID: 0000-0003-0721-0038 Tomsk, Russia

E N Berezikova

Novosibirsk State Medical University

д.м.н., доц. каф. поликлинической терапии и общей врачебной практики ФГБОУ ВО «НГМУ»; ORCID: 0000-0002-9630-0213 Novosibirsk, Russia

S N Shilov

Novosibirsk State Medical University

Email: newsib54@gmail.com
д.м.н., доц. каф. патологической физиологии и клинической патофизиологии ФГБОУ ВО «НГМУ»; ORCID: 0000-0002-7777-6419 Novosibirsk, Russia

A A Popova

Novosibirsk State Medical University

д.м.н., зав. каф. поликлинической терапии и общей врачебной практики ФГБОУ ВО «НГМУ»; ORCID: 0000-0003-2645-162Х Novosibirsk, Russia

E N Samsonova

Novosibirsk State Medical University

д.м.н., проф., зав. каф. патологической физиологии и клинической патофизиологии ФГБОУ ВО «НГМУ»; ORCID: 0000-0001-6986-7305 Novosibirsk, Russia

I V Yakovleva

Novosibirsk State Medical University

ассистент каф. поликлинической терапии и общей врачебной практики ФГБОУ ВО «НГМУ»; ORCID: 0000-0003-4712-2315 Novosibirsk, Russia

A V Molokov

Novosibirsk State Medical University

ассистент каф. поликлинической терапии и общей врачебной практики ФГБОУ ВО «НГМУ»; ORCID: 0000-0001-8718-2801 Novosibirsk, Russia

E V Grakova

Cardiology Research Institute, Tomsk National Research Medical Center

д.м.н., в.н.с. отд-ния патологии миокарда НИИ кардиологии ТНИМЦ; ORCID: 0000-0003-4019-3735 Tomsk, Russia

K V Kopeva

Cardiology Research Institute, Tomsk National Research Medical Center

лаборант-исследователь отд-ния патологии миокарда НИИ кардиологии ТНИМЦ; ORCID: 0000-0002-2285-6438 Tomsk, Russia

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